Ruminative Thinking in Chronic Depression: Concept and Validity of Measures

1524

Abstract

Despite large amount of empirical evidence in support of rumination as a risk factor of depression onset and chronification, theoretical foundations of ruminative thinking are still being discussed. This includes the issue of so-called constructive, or reflec¬tive, ruminations. Objective: This study gives a theoretical review of different views on rumination, empirically tests the idea of constructive and non-constructive rumi¬native thinking, and tests the validity of the Ruminative Response Scale (RRS, Rus sian version) [38]. Study design: We conducted a factor analysis of adapted RRS, as well as an intercorrelational analysis of this scale, Symptom Checklist-90-Revised (SCL-90-r), and the COPE Inventory; hypotheses were tested in a general population group (n=476) and two clinical groups (patients with depressive disorders, n=53, and patients with different diagnoses with recent suicide attempts, n=41). Results: Our theoretical review examines ruminative thinking as a dysfunctional coping strategy (E. Watkins) from the perspective of the structural-dynamic model of thinking in the course of creative problem-solving (V. Zaretsky, A. Kholmogorova). Rumination is conceptualized as getting stuck «in a loop» at certain levels of organization of cognitive processes, which substitutes motivation focus on actual problem solving. The resulting four-factor structure of RRS has good psychometric properties and strong correla¬tions with different psychopathological symptoms and dysfunctional coping strategies (namely, psychological and behavioral avoidance and venting negative emotions); these correlations are found in all resulting factors but one, which implies that it may have a special status. Conclusion: The Russian version of RRS shows good preliminary psychometric characteristics and is viable for practical purposes. The idea of construc¬tive rumination discussed in literature has not been confirmed empirically. ¬

General Information

Keywords: rumination, chronification, depressive disorders, cognitive factors, four-level organization of thinking model, coping strategies, reflection

Journal rubric: Empirical Researches

Article type: scientific article

DOI: https://doi.org/10.17759/cpp.2021290307

For citation: Pugovkina O.D., Syrokvashina A.D., Istomin M.A., Kholmogorova A.B. Ruminative Thinking in Chronic Depression: Concept and Validity of Measures. Konsul'tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2021. Vol. 29, no. 3, pp. 88–115. DOI: 10.17759/cpp.2021290307. (In Russ., аbstr. in Engl.)

References

  1. Alekseev N.G. Proektirovanie uslovii razvitiya refleksivnogo myshleniya. Dissertatsiya v vide nauchnogo doklada na soiskanie uchenoi stepeni doktora psikhologicheskikh nauk. M. 2002. 41 p.
  2. Votrin A.V. Refleksiya i ruminativnoe samokopanie: printsipial’nye otlichiya [Reflection and ruminative introspection: fundamental differences]. III Mezhdunarodnyi s”ezd Assotsiatsii kognitivno-povedencheskoi psikhoterapii: sbornik nauchnykh statei [III International Congress of the Cognitive-Behavioral Psychotherapy Association: collection of scientific articles]. Saint-Petersburg: SINEL, 2017, pp. 13—17.
  3. Dorosheva E.A., Knyazev G.G. Psikhometricheskie svoistva trekh oprosnikov regulyatsii emotsii [Psychometric properties of three emotion regulation scales]. Sovremennye problemy klinicheskoi psikhologii i psikhologii lichnosti: Materialy vserossiiskoi nauchno-prakticheskoi konferentsii s mezhdunarodnym uchastiem [Proceedings of the All-Russian Scientific and Practical Conference with International Participation «Modern problems of clinical and personality psychology»]. Novosib. gos. un-t. Novosibirsk: IPTs NGU, 2017, pp. 193—198.
  4. Zalevsky G.V. Psikhicheskaya rigidnost’ v norme i patologii [Psychological rigidity in health and psychopatology] Tomsk: Izdatel’stvo Tomskogo universiteta. 1993. 272 p.
  5. Zaretsky V.K. Dinamika urovnevoi organizatsii myshleniya pri reshenii tvorcheskikh zadach. Avtoref. diss. na soisk. uch.step. kand.psikhol.n. M.: 1984, 26 p.
  6. Zaretsky V.K., Nikolaevskaya I.A. Metod situatsionno-vektornogo analiza kognitivno-lichnostnogo razvitiya uchashchikhsya v protsesse preodoleniya uchebnykh trudnostei [Situation and Vector Analysis of Cognitive and Personality Development of Students in the Process of Overcoming Learning Difficulties] Kul’turno-istoricheskaya psikhologiya [Cultural-Historical Psychology], 2020, vol. 16 (1), pp. 35—48. DOI:10.17759/chp.2020160104 (In Russ., abstr. in Engl.)
  7. Zaretsky V.K., Semenov I.N. Logiko-psikhologicheskii analiz produktivnogo myshleniya pri diskursivnom reshenii zadach [Logical and psychological analysis of productive reasoning in discursive problem-solving]. Novye issledovaniya v psikhologii [New Studies in Psychology], 1979, № 1, pp. 3—8.
  8. Zaretsky V.K., Kholmogorova A.B. Smyslovaya regulyatsiya resheniya tvorcheskikh zadach [Semantic regulation of creative problem solving], In Ponomarev Ya.A. (eds.) Issledovanie problem psikhologii tvorchestva [Research in Psychology of creativity], Moscow: Nauka, 1983, pp. 62—101.
  9. Zeigarnik B.V., Kholmogorova A.B. Narusheniya samoregulyatsii poznavatel’noi deyatel’nosti u bol’nykh shizofreniei. Zhurnal nevropatologii i psikhiatrii im. S.S. Korsakova, 1985, vol. 85 (12), pp. 1813—1819.
  10. Karlova M.A. Strukturno-dinamicheskie kharakteristiki myshleniya bol’nym s depressivnymi rasstroistvami na materiale resheniya tvorcheskikh zadach [Structural-dynamic characteristcs of thinking of patients with depressive disorders in the study of creative problem solving]. Konsul’tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2013, № 2, pp. 38—61. (In Russ., abstr. in Engl.)
  11. Kolpakov Ya.V., Yaltonskii V.M. Fenomen ruminatsii v strukture trevozhno— depressivnykh perezhivanii u lits molodogo vozrasta [Elektronnyi resurs] [Rumination in anxiety-depressive experiences in young adults]. Meditsinskaya psikhologiya v Rossii: elektron. nauch. zhurn. [Medical Psychology in Russia] 2013. № 3. URL: http://medpsy.ru (Accessed: 19.07.2021).
  12. Krylov V.I. Psikhopatologicheskie osobennosti i diagnosticheskoe znachenie fenomena ruminatsii [Psychopathological features and diagnostical significance of rumination]. Psikhiatriya i psikhofarmakoterapiya [Psychiatry and Psychopharmacotherapy], 2015, № 17, pp. 9—12. (In Russ., abstr. in Engl.)
  13. Kudryavtsev I.A., Lavrinovich A.N. Osobennosti regulyatsii myshleniya pri patologii kharaktera [Cognitive regulation specificities in character pathology]. Voprosy psikhologii [Psychology Issues], 1986, no. 4, pp. 155—162.
  14. Truevtsev D.V., Sagalakova O.V., Zhirnova O.V. [et. al.] Metodologicheskoe osmyslenie fenomena ruminatsii kak mekhanizma podderzhaniya psikhicheskikh rasstroistv [Elektronnyi resurs] [Methodological conceptualization of the rumination phenomenon as a mental disorders maintenance mechanism]. Meditsinskaya psikhologiya v Rossii: elektron. nauch. zhurn. [Medical Psychology in Russia], 2020, № 6. URL: http://mprj.ru (Accessed: 19.07.2021). (In Russ., abstr. in Engl.)
  15. Sirota N.A., Moskovchenko D.V., Yaltonskii V.M. [i dr.] Kognitivnaya terapiya depressivnykh ruminatsii [Cognitive therapy of depressive rumination]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. Spetsvypuski [Neurology and Psychiatry Journal named after Korsakov S.S.: Special issues], 2019, № 1—2, pp. 62—68. DOI:10.17116/jnevro20191191262 (In Russ., abstr. in Engl.)
  16. Faintukh E.D., Kholmogorova A.B. Kommunikatsiya na temu depressii v Internete — faktor psikhopatologii ili resurs dlya psikhoterapii? [Communication About Depression on the Internet — factor of Psychopathology or Resource for Psychotherapy?]. Sovremennaya terapiya psikhicheskikh rasstroistv [Modern therapy of mental disorders], 2021, no. 1, pp. 44—54. DOI:10.21265/PSYPH.2021.39.62.006
  17. Kholmogorova A.B. Kognitivno-bikhevioral’naya terapiya «na grebne tret’ei volny»: revolyutsionnyi povorot ili novye aktsenty? [Cognitive-behavioral therapy «on the crest of the third wave»: a revolutionary new turn or new accents?]. Sovremennaya terapiya psikhicheskikh rasstroistv [Modern therapy of mental disorders]. 2016. no. 2, pp. 16—21. DOI: 10.21265/psyph.2016.0.1758
  18. Kholmogorova A.B., Pugovkina O.D. Osnovnye etapy i napravleniya izucheniya kognitivnykh disfunktsii pri depressiyakh [Elektronnyi resurs] [Cognitive disfunction in depression: main stages and directions of studies]. Meditsinskaya psikhologiya v Rossii: elektron. nauch. zhurn. [Medical psychology in Russia], 2015. № 6. URL: http://mprj.ru (accessed: 19.07.2021).
  19. Beck A.T., Bredemeier K. A Unified Model of Depression: Integrating Clinical, Cognitive, Biological, and Evolutionary Perspectives. Clinical Psychological Science, 2016. Vol. 4 (4), pp. 596—619. DOI: 10.1177/2167702616628523
  20. Beck A.T., Rush A.J., Shaw B.R, Emery G. Cognitive therapy of depression. New York: Guilford Press, 1979, 425 p.
  21. Cano-López J.B., Salguero J.M., García-Sancho E., Ramos-Cejudo J. Testing the Metacognitive Model of Rumination and Depression in Non-clinical Population: New Data about PBRS and NBRS Scales. Journal of Psychopathology and Behavioral Assessment, 2021. Vol. 43, pp. 240—250. DOI: 10.1007/s10862-020-09828-1
  22. He J., Liu Y., Cheng C. et. al. Psychometric Properties of the Chinese Version of the 10-Item Ruminative Response Scale Among Undergraduates and Depressive Patients. Front. Psychiatry, 2021. Vol. 12: 626859. DOI:10.3389/ fpsyt.2021.626859
  23. Lane T.J., Northoff G. Is Depressive Rumination Rational? In Hung T.W., Lane T.J. (eds.), Rationality: Constraints and Contexts. London: Elsevier-Academic Press, 2017, pp. 119—143.
  24. Lyubomirsky S., Layous K., Chancellor J., Nelson S.K. Thinking About Rumination: The Scholarly Contributions and Intellectual Legacy of Susan Nolen-Hoeksema. The Annual Review of Clinical Psychology, 2015. Vol. 11, pp. 1—22. DOI:10.1146/ annurev-clinpsy-032814-112733
  25. Lyubomirsky S., Nolen-Hoeksema S. Self-perpetuating properties of dysphoric rumination. Journal of Personality and Social Psychology, 1993. Vol. 65, pp. 339— 349. DOI:10.1037/0022-3514.65.2.339
  26. Martin L.L., Tesser A. Some ruminative thoughts. In Wyer R.S, Jr. (Ed.) Ruminative thoughts. Advances in Social Cognition, 1996. Vol. IX, pp. 1—47.
  27. Maslej M.M., Mulsant B.H., Andrews P.W. The nature of depressive rumination and its connection with depressive symptoms. Journal of social and clinical psychology, 2020. Vol. 39 (9) , pp.761—787.
  28. McLaughlin K.A., Nolen-Hoeksema S. Rumination as a transdiagnostic factor in depression and anxiety. Behaviour Research and Therapy, 2011. Vol. 49 (3), pp. 186— 193. DOI:10.1016/j.brat.2010.12.006
  29. Miranda R., Nolen-Hoeksema S. Brooding and reflection: Rumination predicts suicidal ideation at 1 year follow-up in a community sample. Behaviour Research and Therapy, 2007. Vol. 45, pp. 3088—3095. DOI:10.1016/j. brat.2007.07.015
  30. Nolen-Hoeksema S. The Role of Rumination in Depressive Disorders and Mixed Anxiety/Depressive Symptoms. Journal of Abnormal Psychology, 2000. Vol. 109 (3), pp. 504—511. DOI:10.1037/0021-843X.109.3.504
  31. Parola N., Zendjidjian X.Y., Alessandrini M. et al. Psychometric properties of the Ruminative Response Scale-short form in a clinical sample of patients with major depressive disorder. Patient Preference and Adherence, 2007. Vol. 11, pp. 929—937. DOI:10.2147/PPA.S125730
  32. Roberts H., Jacobs R.H., Bessette K.L. et al. Mechanisms of rumination change in adolescent depression (RuMeChange): study protocol for a randomised controlled trial of rumination-focused cognitive behavioural therapy to reduce ruminative habit and risk of depressive relapse in high-ruminating adolescents. BMC PSYCHIATRY, 2021. Vol. 21 (1). DOI: 10.1186/s12888-021-03193-3
  33. Rogers M.L., Joiner T.E. Rumination, Suicidal Ideation, and Suicide Attempts: A Meta-Analytic Review. Review of General Psychology, 2017. Vol. 21 (2), pp. 132— 142. DOI:10.1037/gpr0000101
  34. Satyshur M.D., Layden E.A., Gowins J.R. et al. Functional connectivity of reflective and brooding rumination in depressed and healthy women. Cognitive, Affective, & Behavioral Neuroscience, 2018. Vol. 18, pp. 884—901. DOI:10.3758/s13415-018- 0611-7
  35. Sevcikova M. et al. the Analytical Rumination Hypothesis: Exploring the Longitudinal Effects of Problem Solving Analysis on Depression. Front. Psychol, 2020, no. 11. DOI: 10.3389/fpsyg.2020.01344
  36. Smith J. M., Alloy L.B. A roadmap to rumination: A review of the definition, assessment, and conceptualization of this multifaceted construct. ClinPsychol Rev. 2009. Vol. 29 (2), pp. 116—128. DOI:10.1016/j.cpr.2008.10.003
  37. Sumner J.A. The mechanisms underlying overgeneral autobiographical memory: An evaluative review of evidence for the CaR-FA-X model. Clinical Psychology Review, 2012. Vol. 32, pp. 34—48. DOI:10.1016/j.cpr.2011.10.003
  38. Treynor W., Gonzalez R., Nolen-Hoeksema S. Rumination Reconsidered: A Psychometric Analysis. Cognitive Therapy and Research, 2003. Vol. 27 (3), pp. 247—259. DOI:10.1023/A:1023910315561
  39. Tang H., Xiong T., Shi J. et al. Global and reflective rumination are related to suicide attempts among patients experiencing major depressive episodes. Psychiatry, 2021. Vol. 21, p. 117. DOI:10.1186/s12888-021-03119-z
  40. Watkins E.R. Constructive and Unconstructive Repetitive Thought. Psychological Bulletin, 2008. Vol. 134 (2), pp. 163—206. DOI:10.1037/0033-2909.134.2.163
  41. Watkins E.R., Scott J., Wingrove J. et. al. Rumination-focused cognitive-behaviour therapy for residual depression: a case series. Behaviour Research and Therapy, 2007. Vol. 45 (2), pp. 144—154. DOI:10.1016/j.brat.2006.09.018
  42. Watkins E.R. Rumination-focused cognitive-behavioral therapy for depression. New York: Guilford, 2016. 349 p.
  43. Wells A. Metacognitive therapy for anxiety and depression. New York: Guilford Press, 2009. 316 p.
  44. Wells A. Breaking the cybernetic code: Understanding and treating the human metacognitive control system to enhance mental health. Frontiers in Psychology. 2019, vol. 10. DOI:10.3389/fpsyg.2019.02621.
  45. Zhou H.-X., Chen X., Shen Y.-Q. et al. Rumination and the default mode network: Meta-analysis of brain imaging studies and implications for depression. NeuroImage, 2020, vol. 206. DOI:10.1016/j.neuroimage.2019.116287

Information About the Authors

Olga D. Pugovkina, PhD in Psychology, Assistant Professor, Chair of Clinical Psychology and Psychotherapy, Department of Clinical and Counseling Psychology, Moscow State University of Psychology & Education, Senior Research Associate, Department of Clinical Psychology and Psychological Counseling, Moscow Research Institute of Psychiatry — Branch of The Serbsky Federal Medical Research Center for Psychiatry and Narcology, Moscow, Russia, ORCID: https://orcid.org/0000-0003-2878-9843, e-mail: olgapugovkina@yandex.ru

Anna D. Syrokvashina, graduate student, Moscow State University of Psychology & Education, Moscow, Russia, ORCID: https://orcid.org/0000-0003-0691-0892, e-mail: asyrokvashina@gmail.com

Mikhail A. Istomin, Medical Psychologist, Sklifosovsky Research Institute of Emergency Сare, Moscow, Russia, ORCID: https://orcid.org/0000-0002-5713-3766, e-mail: stominmikhailan@gmail.com

Alla B. Kholmogorova, Doctor of Psychology, Professor, Dean of the Faculty of Counseling and Clinical Psychology, Moscow State University of Psychology & Education, Leading Researcher, Moscow Research Institute of Psychiatry (A Branch of the National Medical Research Centre for Psychiatry and Narcology), Moscow, Russia, ORCID: https://orcid.org/0000-0001-5194-0199, e-mail: kholmogorova@yandex.ru

Metrics

Views

Total: 1653
Previous month: 49
Current month: 70

Downloads

Total: 1524
Previous month: 44
Current month: 37